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High co-payments hinder diabetes treatment

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Newswise — Actively managing diabetes is important to prevent long-term health complications, but rising costs are a barrier to treatment.

Diabetes is currently most expensive chronic disease Nationally, according to the Centers for Disease Control and Prevention.of total cost of diabetes Healthcare spending in 2022 will exceed $400 billion, accounting for a quarter of all healthcare spending in the United States.

According to a Michigan Medicine study published in Diabetes research and clinical practice, People with diabetes, especially those with type 1 diabetes, face high out-of-pocket costs. compared to people without diabetes.

The researchers used a national health insurance claims database to match subjects with similar demographics to ensure comparable populations with type 1 diabetes, type 2 diabetes, and those without diabetes.

Investigators tracked total costs and out-of-pocket expenses from 2009 to 2018, as well as medication costs, diabetes supplies, visits to health care providers, hospitalization costs, and emergency room visits.

The research team found that type 1 diabetes had the highest total costs and out-of-pocket costs in 2018, at $25,652 and $2,037, respectively.

Type 2 diabetes followed closely in both total costs and out-of-pocket costs, while those without diabetes paid significantly less, paying an average of $14,220 total and $1,122 out-of-pocket.

From 2009 to 2018, total costs increased for all three groups, but only patients with type 1 diabetes saw an increase in out-of-pocket costs.

“If the trends we have observed continue, people with type 1 diabetes will increasingly face unaffordable out-of-pocket costs,” said the first author. Dr. Evan Reynolds, Chief Statistician for the Michigan Medical Society’s NeuroNetworks for Emerging Therapies.

Rising drug prices are a major driver of this trend, accounting for the largest portion of out-of-pocket costs regardless of diabetes status.

Hypoglycemic drugs, especially insulin, have been steadily increasing in price for both type 1 and type 2 diabetes.

“Studies show that the higher a patient’s out-of-pocket costs, the less likely they are to stay on their medications long-term, which poses serious health risks,” Reynolds said.

In addition to expensive medications, people with type 1 diabetes also face increased costs for diabetes management supplies such as syringes, pumps, and diabetes test strips.

“We are concerned that patients cannot afford preventive health services,” said the lead author. Dr. Brian Callahana neurologist at Michigan Health University; Eva L. Feldman, MDProfessor, Department of Neurology, UM School of Medicine.

“Diabetes prevention measures not only have health benefits, but they can also save you money in the long run.”

According to the researchers, the out-of-pocket costs for these treatments can be significant for patients; economic toxicity.

“Economic toxicity is when health care costs begin to negatively impact every aspect of a patient’s life, impacting both their physical and mental health,” Reynolds said.

“Diabetes health care providers should be proactive in screening for the side effects of these costs and looking for signs of depression or anxiety.”

People living with type 1 diabetes are particularly at risk of economic toxicity. What is the first step to combat this? Reynolds says it could reduce the cost of blood sugar-lowering drugs.

“We need to enact policies that reduce or stabilize out-of-pocket costs and encourage people to properly treat their diabetes,” he said.

“Reducing the price of insulin is an urgent need at this time, as pharmaceuticals are at the top in terms of cost and usage.”

Additional authors: Department of Internal Medicine, Department of Metabolism, Endocrinology, and Diabetes, University of Michigan, Kara Mizokami Stout, Lynn Anne, and Rodica Pop-Busui; Nathaniel Putnam and Moosmi Banerjee of the University of Michigan’s Department of Biostatistics; Dana Albright and Joyce Lee of the Division of Pediatric Endocrinology, Department of Pediatrics, University of Michigan;

Funding/Disclosure: Dr. Lee is a member of GoodRx’s Medical Advisory Board. Dr. Pop-Busui has received research support from Metronic, Novo Nordisk, and consults for Novo Nordisk, Regenacy, Roche, Procter &Gamble, Averitas, and Nevro. Dr. Feldman consults for Biogen. Dr. Callahan serves as a consultant to Dynamed, receives research support from the American Academy of Neurology, and provides medico-legal consultation, including consultation on the Vaccine Injury Compensation Program.

Quote: ““Cost and utilization of medical services for patients with diabetes” National Library of Medicine: National Center for Biotechnology Information. Doi: 10.1016/j.diabres.2023.110983

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